Healthcare Implications for Facebook’s New “Graph Search” Functionality

By @Spitz

Social media has, since inception, been the agony and ecstasy for health communicators. On the one hand privacy concerns and the potential for abuse exponentially mount with the more open and often indiscriminate sharing of personal health data, while on the other the free, easy, and transparent flow of information is the very life blood of patient, caregiver, and healthcare professional education, guidance, and support.

As a result, anyone engaging with health and healthcare related user-generated content walks a swaying tightrope between exposing themselves to significant risk, and reaping the amazing benefits. The paradox is that the better these social media channels get at enabling and encouraging engagement, the greater the potential rewards and headaches—especially when platforms like Facebook feel tremendous pressure to monetize, forcing their hand at driving social experiences into that of eCommerce conversions.

Why “Graph Search”?

Analogous to Google the search king trying to enter the social space with Google Plus, Facebook the social queen is now trying to capture the search space with Graph Search. The Holy Grail is actually neither search nor social per se, but increased digital user engagement that ultimately translates to higher revenue for these providers.

Although Google is a technological giant with depth and breadth from Morotola to Zagat’s, their principal money machine remains pay-per-click advertising, fueled by clickthroughs of contextual advertising on their search results page. Threatened by Facebook’s astronomical levels of user engagement, Google understands that in order to get those eyeballs and asses back, they’ll have to play successfully in the social space, too.

Facebook interestingly enough has the opposite problem of Google: FB has unprecedented levels of user engagement, but not the monetization. So Zuckerberg and Company have known for years they would eventually have to explore the reverse path, namely integrating search functionality into their already highly successful social experience.

Add to this mix mobile, a vexing problem for both Google and Facebook. As digital real estate has shrunk with smaller and more practical screen sizes, room to place ads has also waned, deeply impacting revenue. Fixing this problem goes beyond retooling the interface, however, since users are naturally engaging less and less frequently with contextual ads, even on a desktop, as demonstrated by Facebook’s calamitous IPO. What’s clearly missing is a change in not only how these ads appear, but in the very nature of “contextual” placement; the more branded content and a call-to-action becomes organically a part of a digital social experience, the greater the likelihood for a conversion–including and especially in mobile.

Thus “Graph Search,” the question being not why they’ve done it, but what’s taken them so long? The answer is both behavioral and technological. Far as users go, good old fashioned Ries & Trout marketing rules have more power than any R&D: Google is search, Facebook is social, and never the twain shall meet. When people socialize they don’t search, and when they search, they don’t socialize. And when on a mobile device, with less room and less time to spare, these behaviors are even more distinct. At least for now…

That explains why Google Plus has, by any stretch of the imagination, not met CEO Larry Page’s goals, and why Facebook has had such a tough time growing up. The lesson is that entrenched mindshare changes very slowly, and once it’s been set, is extremely difficult to transform. Remember Xerox Computers and Cherry Coke? All flops, because Xerox was and remained a copier, and line extensions almost never work for iconic, entrenched consumer goods. Google tried to forcefully merge functionality with “social search,” but relented; users didn’t buy it.

On the tech side, successfully integrating search functionality into Facebook is very hard: From the back end you have pentabytes of data in countless categories from a billion users; on the front end you have the Facebook Timeline and Newsfeed, of which search would have to be another separate yet seamlessly integrated user experience. As business leaders have learned, Zuckerberg a prime example, it’s tough being Number One in your industry, since keeping your pole position is often more difficult than trying to get it.

Back to Graph Search, better late than never, as inevitable as it will be surprising, a step in the right direction for Facebook, but for our purposes here: What does it mean for health and healthcare communicators? And what might it mean for pharma and medical device marketers?

What is “Graph Search”?

Before we can talk about implications, we need to understand what it does. Since beta isn’t released as of this posting, all we can go by is what Zuck shared during his presentation of the functionality. Specifically, a blue bar will run across the top with an entry field. Instead of typing in simple keywords, the expectation will be to type in whole questions regarding friends and friend preferences—more like Wolfram Alpha than Google.

For example, a user would type in “Do I have any friends renting apartments in Chicago?” or “Did any of my friends see LIFE OF PI yet?” or “What do my friends think about Muir Woods in San Francisco?” Graph Search will then analyze the mountains of interconnected and tagged data throughout the user’s own network, and produce responses that, according to Zuckerberg, aren’t links, but informative pieces of content in the form of posts, pics, movies, and the like. Search results will mostly likely be sharable with friends, since why not, that’s what Facebook does best.

The functionality will also go beyond friend data to access public domain content, in a manner that has yet to be fully described. Using Microsoft’s Bing as its search engine, the results page for Graph Search should be very, very interesting indeed. Presumably mashing up friend results with public domain results, the experience begs the question regarding the difference between “search” and “social” content. How they will mesh and be prioritized is anyone’s guess, and is still a Facebook work-in-progress, dependent as much on user metrics as back end tech.

Celebrated as Facebook’s “Third Pillar” alongside Timeline and Newsfeed, the potential for Graph Search is intimidating and astonishing. If successful, this late-coming widget stepchild could and probably should consume most of the Facebook UX. After all, the ultimate goal here is to drive users to branded content that either indirectly or directly results in a monetary conversion—“What do my friends think about Muir Woods in San Francisco?” bringing up their favorite hotels in the area, restaurants, souvenirs, galleries of gorgeous red woods—All ostensibly making Facebook not only a direct competitor to Google, but Amazon! The big question, however, is if users will be able to evolve along with the intent of the designers.

What does “Graph Search” mean for Health and Healthcare?

Ah, now here’s the rub. If you’ve been following this harangue so far, then yellow and red digital health lights should already be flashing. Not much imagination is required to wonder what will happen when a user types in, for example “What do my friends think about HIV?” or “Do any of my friends have erectile dysfunction?” or “Have any of my friends had a bad reaction to taking Drug X?” “What do you think about Dr. Y?” “How was your stay at hospital Z?” If you’re a pharmaceutical or medical device manufacturer regulatory attorney, or a hospital admin, or even a patient who wants to keep things very personal, I bet you’re experiencing a mild myocardial by now…

Facebook stressed that Graph Search will only access individual friend content and public domain data through Bing. But from a healthcare point of view, that doesn’t help much at all. The reason is that in digital what’s being shared is sometimes secondary to how it’s shared. Prioritization and access mean everything. The data might be out there, but it’s normally not readily available. What Graph Search essential does is filter, sort, and aggregate specific kinds of data, driving for some kind of action. If you’re looking for a hotel to stay at or choose a power saw that’s fine, but if you’re self-diagnosing a disease or choosing a doctor, or for that matter marketing a drug or device or institution, things could get ugly, fast.

These concerns are only the tip of the healthcare privacy and adverse event iceberg. All of a sudden, every post, every comment, every upload you’ve ever made to Facebook becomes funneled into search results that any of your friends can access, under criteria you can never fully anticipate. This information is also contextual, based on limitless possible search parameters. And how will this data be filtered? How will it be presented? What ancillary information will be presented with it? What calls-to-action will drive the users, and where?

Here’s a hypothetical scenario, just making this up: I enter “Who’s going to go see DJANGO UNCHAINED in Chelsea this evening?” Graph Search shares an array of results, presumably theatres in the area showing the film, film reviews posted by critics and friends who have seen it—but what if a friend checked-in or referred, even obliquely, to a Hep C clinic in the area? What if another friend got prescribed a medication from Chelsea Therapeutics? What if another has an oncologist named Dr. Django? Yet another friend “unchained” from their embarrassing erectile dysfunction condition, sharing it with a close friend, but not intending it for his coworkers? I’m riffing here, but it’s not difficult to see the potential health communications and privacy train wrecks. And I’m only talking about raw textual content here; imagine the added complexities of tagged Instragram photos, charts or graphs, family pictures…

More frightening still, the recent beta release reveals nightmare scenarios where results are generated for such obnoxious queries as “Married people who like prostitutes” and “Current employers of people who like racism” — doesn’t take much to extrapolate these into the healthcare area, with alarmingly objectionable searches such as “Diabetics who like snacks,” “Bowling buddies who like erectile dysfunctional medication,” or “Dr. Django’s patients who like the better business bureau,” as even a structured search protocol such as “X of Y or like Z” can lead to irrelevant, erroneous, and potentially disastrous results when privacy, reputation management, and adverse event reporting remain at the forefront of healthcare communications risk in the social space.

On the marketing side of the house, anything and everything posted by pharma and device companies, in branded or unbranded form, and subsequently interacted with or Liked on Facebook, will automatically feed into Graph Search results. Perhaps and most likely a “Do Not Enable Search” feature will be added to Timeline Pages, but the complicated relationships between all pages on Facebook will make content bleed, especially with a powerful aggregation tool such as Graph Search, inevitable. Similar rules apply to physicians, specialists, hospitals, clinics…. How will you, as a healthcare communicator, know where and in what form your content will appear and re-appear across Facebook? The answer is, you won’t.

What’s intensely paradoxical in all this, however, is that if Graph Search succeeds, healthcare companies will eventually want to play ball. As users become increasingly accustomed to search, social, and shopping morphing into a more seamless, holistic user experience, the entrenched boundaries will dissolve, and with them our more traditional notions or privacy, risk, and potentially even adverse event monitoring, management, and reporting. But until then, digital health communicators beware!

Key Takeaways and Recommendations

If you thought Facebook was an exciting but frightening place for health and healthcare, well it just got even more intense. By finally entering into the search arena, Facebook is not only introducing old social media problems, but compounding entirely new and unexplored ones where social, search, and eCommerce collide.

Their confluence is where digital is headed, but who will get there and how remains to be seen. The future of Facebook, Google, Apple, Microsoft, and even Amazon depend on the answer to this question; they’re all in the same race, but I wouldn’t be surprised if an as-yet unknown fresh face induces paradigm shift, akin to Mr. Zuckerberg’s rise from Harvard dorm room to global digital dominion.

So what should you, as a digital health expert, do? If you’re a pharma or device marketer with content already on Facebook, double-check compliance, and get comfortable with bits and pieces potentially becoming aggregated outside the context of where they appear. (Red flags for fair balance information, obviously.) If you’re a hospital or private practice physician, be mindful that having patient FB friends might mean that your interactions could become more readily accessible to your patient’s entire friend network. The open door is now spinning wildly, further reinforcing the maxim that you should only post on Facebook (and any social channel) that which you are perfectly comfortable indiscriminately sharing with the world.

Caution is best, especially until we see that Graph Search results page and experience. Rest assured, however, that this is only the beginning of inexorable search/social/shopping integration, a trend that will become the standard user experience in only a few years. Get ready, because none of us have any choice. And those savvy healthcare marketers who can visualize the inevitable will have the best skin in the game when the user experience finally catches up to the technology, and these isolated platforms finally merge. Graph this!

Share your own thoughts below! Eager to hear you opinions.

Michael Spitz , known most often as just "Spitz," is Editor-in-Chief of the Pixels & Pills and a prollific tweeter, blogger, and article writer, active in digital health across all specialties. Follow him @SpitzStrategy.



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